Ward_X

The bags are engineered with a sort of "breathable" membrane, so you could, in a way, poison the product. We have found floors trying to wipe down units with bleach before they come back to the Blood Bank, which totally isn't okay !!!! but, they wouldn't know otherwise. The products would have to be discarded,

Same as many above, also use saline as a neg. control for CC so it's "accidentally" QC'd. The cubes are also inspected on a daily basis as part of the Cellwasher QC, which checks for valid expiration date of 30d on the cube and that there is sufficient volume. Switched over to PBS somewhat recently, all the procedures were modified.

I wondered the same thing, both about units and the samples from the patients. The only related thing I could think of are policies regarding CJD/vCJD, and those only covered samples. Besides following universal precautions and wearing the necessary PPE, seems to me the only difference is vigorous cleaning of non-disposable equipment with bleach after testing and that samples sent to micro are handled under BSL-3. Another point, you don't know the status of every single patient getting blood products, so do you even know who had Flu B before all this madness?

I'm hoping our donor supply remains strong and healthy donors don't get scared off from giving blood.

You could be neglecting potential transfusions in other facilities; what is the rationale for not checking this tab in Epic?

My facility's previous control was running the previous sample in tandem and the results had to agree within one dilution. This process is currently being remodeled.

Reminds me of a recent forum post I read elsewhere about someone who wanted to give a patient with an anti-Vel phenotypically negative units from family members that actually were still genetically variant. The consensus was molecular negative donor units only!

If you're talking about resolving an ABO with the presence of a cold, I've seen using warmed cells/plasma, adsorbed plasma, or cord cells. Did they use the anti-IgG for the workup, and not the discrepancy?

How does your facility comply with the newer AABB standard 5.16.2.2? Wouldn't compliance with having two determinations of an ABO group prevent erroneous admission?

I graduated from an MLS program in the last 5 years and I had two semesters of clinical chemistry, two semesters of clinical microbiology, one semester hematology, and one semester immunohematology. You can imagine my surprise when I came around in my clinical rotations and tried to grasp what an adsorption was, ha! Anyway, students tend to have a harder time going through Blood Bank for that reason.

From what I've seen, these patients normally have type-specific instructions for all products listed in their file. For example, for current in-process transplants, an OtoA Pos patient may have an O Red Cell Products instruction, an A or AB Plasma instruction, and an A, AB, or washed platelet instruction. If they have fully switched over to the donor type, their file notes that instead, and then it's type specific from there...

I have heard of facilities using TEG or ROTEM.

My facility uses Helmers and we have racks manufactured by Astron Systems. They store units vertically in sets of two or four. You can fit 4 across the length of a Helmer fridge in 2 rows (so 8 racks of 4, 32 total). In the Helmers with a higher bulk of products, we have some sort of plastic/acrylic dividers that section of units. We also have longer/heavier plastic "sleeves" that go down the length of the shelf, and those fit ~15 bags and go three across. So, I guess we have a lot of options! Intrigued to hear others!

Looking again at the Circular, FFP should be infused immediately after thawing, or discarded after 24hrs if not refrigerated. The Technical Manual references that components prepared in an open system require a reduction in expiry time from the time the system was opened. But, use of approved sterile collection devices maintains a closed system instead, allowing actions such as pooling or sampling to maintain the original expiration date/time. Thawed plasma is derived in a functionally closed system. I do not see any mentions of pooling in an open system -- only for platelets and cryo, with cryo having a 4hr outdate for an open system. The only mentions of pooled plasma was in regards to pathogen-reduced plasma, which had a 24 outdate from thaw. There is a section in the Technical Manual called Pooling under the Whole-Blood Collection and Component Processing chapter. You can also reference Table 9-1 Requirements for Storage, Transportation, and Expiration to see all the product types and their expirations. Are you talking about pooling for fractionation?

I can reply to this now that our Christmas Eve MTP has calmed down